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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.42 no.4 São Paulo Dec. 1984 

Peripheral nerve involvement in Bell's palsy


Comprometimento nervoso periférico na paralisia de Bell



J. A. BueriI; L. G. CohenII; Marcela E. PanizzaIII; Olga P. SanzIV; R. E. P. SicaV

IChief of Residents in Neurology. Department of Electroneurophysiology, Neurology Division, J. M Ramos Mejia Hospital (Buenos Aires, Argentina)
IIFormer Resident in Neurology. Department of Electroneurophysiology, Neurology Division, J. M Ramos Mejia Hospital (Buenos Aires, Argentina)
IIIFormer Chief of Residents in Neurology. Department of Electroneurophysiology, Neurology Division, J. M Ramos Mejia Hospital (Buenos Aires, Argentina)
IVStaff Neurologist. Department of Electroneurophysiology, Neurology Division, J. M Ramos Mejia Hospital (Buenos Aires, Argentina)
VHead of the Electroneurophysiology Department. Department of Electroneurophysiology, Neurology Division, J. M Ramos Mejia Hospital (Buenos Aires, Argentina)




A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.


Um grupo de pacientes com paralisia de Bell foi estudado com o objetivo de descobrir a presença de comprometimento nervoso periférico subclínico. 20 pacientes, 8 homens e 12 mulheres com paralisia de Bell recente como única enfermidade, foram examinados. Em todos os casos outras causas de polineuropatia foram excluídas. Os pacientes foram estudados com exames de líquido cefalorraqueano; latência distal nos nervos faciais do lado afetado e do lado sadio e velocidade de condução motora máxima; latência distal dos nervos mediano e peroneiro direitos. O exame de LCR foi normal em tcdos os casos. A latência do nervo facial foi anormal em todos os pacientes no lado afetado e, no lado clinicamente sadio, diferia significativamente do grupo controle. A metade dos pacientes mostrou valores anormais na velocidade motora máxima e/ou na latência distal de ambos os nervos, como sejam: mediano e peroneiro. Esses resultados estão de acordo com publicações anteriores nas quais se afirma que outros nervos craneanos podem estar afetados na paralisia de Bell. Temos encontrado uma elevada frequência de polineuropatia nesta enfermidade. Estes achados nos levam a crer que, em alguns enfermos, a paralisia de Bell é um componente de uma doença mais disseminada afetando outros nervos craneanos e periféricos.



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Hospital J. M. Ramos Mejia, Division de Neurologia, Sección de Electroneurofisiologia - Urquiza 609, Buenos Aires - Argentina.

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